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目的总结外科手术联合腹腔局部热灌注化疗治疗腹膜间皮瘤的临床疗效,以期提高对恶性腹膜间皮瘤的认识和治疗水平。方法采用回顾性分析方法,8例恶性腹膜间皮瘤患者治疗方式为手术肿瘤切除和部分切除,手术后1周开始采用生理盐水2000ml+5-氟脲嘧啶500mg+顺铂100mg为化疗液,腹腔热灌注化疗,1次/周,共4次。结果术后3个月随访时,2例弥漫型因癌肿广泛侵袭及转移于术后3个月内死亡,6例存活(其中1例为弥漫型,5例为局限型)。9个月随访时,1例弥漫型者术后6个月复发,行全身化疗3个月后死亡。2例2年后死亡。目前3例存活,分别为治疗后存活2年、超过5年及达6年8个月。结论恶性腹膜间皮瘤恶性程度高,临床无特异表现,尽早施行减瘤术+腹腔局部热灌注化疗能提高生存率。
Objective To summarize the clinical efficacy of surgical combined with intraperitoneal hyperthermic perfusion chemotherapy in the treatment of peritoneal mesothelioma, in order to improve the understanding and treatment of malignant peritoneal mesothelioma. Methods A retrospective analysis was performed. Eight cases of malignant peritoneal mesothelioma were treated by surgical tumor resection and partial resection. One week after the operation, normal saline 2000ml + 5-fluorouracil 500mg + cisplatin 100mg was used as chemotherapy solution and abdominal heat Infusion chemotherapy, 1 / week, a total of 4 times. Results After 3 months of follow - up, 2 patients with diffuse type extensive invasion and metastasis due to cancer died within 3 months after operation, and 6 patients survived (1 was diffuse and 5 were localized). At 9 months of follow-up, one patient with diffuse type relapsed 6 months after surgery and died after 3 months of systemic chemotherapy. 2 cases died after 2 years. Currently 3 patients survived, survived for 2 years after treatment, more than 5 years and up to 6 years and 8 months. Conclusion Malignant peritoneal mesothelioma has high malignant degree and no specific clinical manifestations. As soon as possible, cytoreduction and peritoneal hyperthermic perfusion chemotherapy can improve the survival rate.